US9011362B2 - Method of treating COPD with artificial arterio-venous fistula and flow mediating systems - Google Patents

Method of treating COPD with artificial arterio-venous fistula and flow mediating systems Download PDF

Info

Publication number
US9011362B2
US9011362B2 US13/529,364 US201213529364A US9011362B2 US 9011362 B2 US9011362 B2 US 9011362B2 US 201213529364 A US201213529364 A US 201213529364A US 9011362 B2 US9011362 B2 US 9011362B2
Authority
US
United States
Prior art keywords
fistula
flow
vein
method
artery
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
US13/529,364
Other versions
US20120316487A1 (en
Inventor
Rodney A. Brenneman
J. Christopher Flaherty
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Rox Medical Inc
Original Assignee
Rox Medical Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US11/013,981 priority Critical patent/US8226592B2/en
Application filed by Rox Medical Inc filed Critical Rox Medical Inc
Priority to US13/529,364 priority patent/US9011362B2/en
Assigned to ROX MEDICAL, INC. reassignment ROX MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: FLAHERTY, J. CHRISTOPHER, BRENNEMAN, RODNEY A.
Publication of US20120316487A1 publication Critical patent/US20120316487A1/en
Application granted granted Critical
Publication of US9011362B2 publication Critical patent/US9011362B2/en
Application status is Active legal-status Critical
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another
    • A61M27/006Cerebrospinal drainage; Accessories therefor, e.g. valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027Type of occlusion
    • A61B17/12036Type of occlusion partial occlusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12027Type of occlusion
    • A61B17/1204Type of occlusion temporary occlusion
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12136Balloons
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132Tourniquets
    • A61B17/135Tourniquets inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621Extra-corporeal blood circuits
    • A61M1/3653Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3655Arterio-venous shunts, fistulae
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00243Type of minimally invasive operation cardiac
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831Material properties
    • A61B2017/00876Material properties magnetic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1107Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1135End-to-side connections, e.g. T- or Y-connections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/11Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
    • A61B2017/1139Side-to-side connections, e.g. shunt or X-connections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1052Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/04General characteristics of the apparatus implanted
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/35Communication
    • A61M2205/3507Communication with implanted devices, e.g. external control
    • A61M2205/3515Communication with implanted devices, e.g. external control using magnetic means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00Anatomical parts of the body
    • A61M2210/12Blood circulatory system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00Anatomical parts of the body
    • A61M2210/12Blood circulatory system
    • A61M2210/127Aorta
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00Measuring parameters of the user
    • A61M2230/005Parameter used as control input for the apparatus
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00Measuring parameters of the user
    • A61M2230/20Blood composition characteristics
    • A61M2230/202Blood composition characteristics partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00Measuring parameters of the user
    • A61M2230/20Blood composition characteristics
    • A61M2230/205Blood composition characteristics partial oxygen pressure (P-O2)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00Measuring parameters of the user
    • A61M2230/40Respiratory characteristics
    • A61M2230/46Resistance or compliance of the lungs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02Access sites
    • A61M39/0208Subcutaneous access sites for injecting or removing fluids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/22Valves or arrangement of valves
    • A61M39/28Clamping means for squeezing flexible tubes, e.g. roller clamps

Abstract

A method for treatment of COPD, hypertension, and left ventricular hypertrophy, and chronic hypoxia including creation of an artificial arterio-venous fistula and installation of a flow mediating device proximate the fistula. The flow mediating device is operated to limit flow as medically indicated to provide the optimum amount of bypass flow.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 11/013,981, filed Dec. 15, 2004, the content of which is incorporated herein by reference in its entirety.

FIELD OF THE INVENTIONS

The inventions described below relate to treatments for pulmonary hypertension and vascular surgery.

BACKGROUND OF THE INVENTION

Chronic obstructive pulmonary disease (COPD), chronic hypoxia, hypertension, and left ventricular hypertrophy and pulmonary hypertension are diseases of the cardiopulmonary system. Chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, is a slowly progressive lung disease caused primarily by smoking In COPD, the lungs are damaged and the airways are partly obstructed, making it difficult to breath and leading to a gradual loss of lung function. Symptoms of COPD include chronic cough, excessive sputum production, low blood oxygen levels and severe disabling shortness of breath. COPD represents the fourth leading cause of death in the United States. Chronic hypoxia (reduction of oxygen supply to the body despite adequate blood flow through the body), hypertension, and left ventricular hypertrophy are related conditions which may be symptomatic of COPD or coincident with COPD.

These serious conditions affect many people, and the primary treatments are merely ameliorative. The primary treatments for COPD include avoidance of irritants such as tobacco smoke and breathing supplemental oxygen. In advanced cases of COPD, lung reduction surgery is sometimes performed, but it is not clear that it helps. There is no known cure for COPD.

An aortocaval fistula (ACF) is a rare clinical condition that can be either spontaneous (80% of the cases), related to abdominal aortic aneurysm, or the result of some trauma such as lumbar disk surgery. It is currently seen as a defect that should be cured with surgery and, possibly, stent-graft implantation in the aorta. Likewise, arterio-venous fistulas are uncommon, and can be caused by trauma or may be iatrogenic (i.e., an unintended result of vascular intervention, as discussed in Ruebben, et al., Arteriovenous fistulas induced by femoral arterial catheterization: percutaneous treatment, 209 Radiology, 729 (1998)). Arteriovenous fistulas are also seen as defects that should be cured with surgery and, possibly, stent-graft implantation.

Contrary to this understanding, an intentionally formed aortocaval fistula appears to be a viable treatment for COPD. Recently, in our co-pending U.S. patent application Ser. No. 10/820,169 filed Apr. 6, 2004, entitled Implantable Arteriovenous Shunt Device and listing John L. Faul, Toshihiko Nishimura, Peter N. Kao & Ronald G. Pearl as inventors (the entirety of which is hereby incorporated by reference), we propose creation of an artificial aortocaval fistula as a treatment for COPD, and we disclose the method of creating the fistula and an implantable shunt for maintaining the aortocaval fistula. In our co-pending U.S. patent application Ser. No. 10/927,704 filed Aug. 27, 2004 (the entirety of which is hereby incorporated by reference) we disclose a vascular shunt rivet which serves to hold contiguous points of the patient's aorta and inferior vena cava (or other arteries and their associated veins, such as the femoral artery and femoral vein, or the carotid artery and the carotid vein) together and maintain an open flow path from the aorta to the vena cava. The device functions as a rivet, holding the two vessel walls in close proximity, and as a shunt, permitting and maintaining flow from one blood vessel to the other as a treatment for COPD.

The method of treating COPD by creating an artificial arterio-venous fistula and maintaining the fistula with an endoprosthesis may be improved with the addition of mechanisms for adjusting the arterial bypass flow rate to optimum levels. Adjustments to flow may be made to balance the positive effects of injecting oxygenated blood into the venous system with the potential negative effects.

BRIEF SUMMARY OF THE INVENTION

The devices and methods described below provide for treatment of COPD, hypertension, and left ventricular hypertrophy, and chronic hypoxia. After creation of an artificial arterio-venous fistula, a flow mediating device is installed proximate the fistula (directly on the fistula, immediately upstream of the fistula in the artery, or immediately downstream of the fistula in the vein). In one embodiment of the method, a bladder is installed proximate the vein, artery or the fistula itself, and is inflated to impinge upon the vein, artery or the fistula to limit bypass flow through the fistula. Other mechanisms for controlling flow are also proposed, including shunts (placed to maintain the fistula) having mechanisms for throttling flow through the shunt, and even prior art screw operated clamps for compressing some portion of the flow path.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates the method of creating an artificial arterio-venous fistula and controlling flow with a balloon impinging on the artery.

FIG. 2 is a detail view of the inflatable cuff and its associated components, installed over the femoral vein of the patient.

FIG. 3 illustrates installation of the cuff over the left femoral artery.

FIGS. 4, 5 and 6 illustrate use of bladder which merely impinges on the femoral vein to control bypass flow.

FIGS. 7 and 8 illustrate a bladder assembly which assists in operably coupling the bladder to the blood vessel.

FIG. 9 shows the bladder assembly of FIG. 8 disposed in impinging relationship with the anatomical fistula.

FIGS. 10 and 11 illustrate use of shunt with an integral bladder, which may be inflated to control flow through the shunt, as desired to affect the arterial bypass flow as treatment for COPD.

FIGS. 12 and 13 illustrate another mechanism for regulating fistula bypass flow, in which a membranous wall of the shunt may be magnetically drawn to control the size of the shunt lumen.

DETAILED DESCRIPTION OF THE INVENTION

FIG. 1 illustrates the method of creating an artificial arterio-venous fistula and controlling flow with a balloon impinging on the artery. A portion of the vasculature of the patient 1 is shown, illustrating the left and right femoral artery/external femoral arteries 3L and 3R, the left and right common iliac arteries 4L and 4R, and the abdominal aorta 5. Portions of the venous system are also illustrated the vena cava 6, which runs parallel to the aorta, and is typically contiguous with the aorta, the left and right femoral veins 9L and 9R. An artificial arterio-venous fistula or side-to-side anastomosis 7 may be formed between the femoral vein and femoral artery on either side of the body, indicated as items 10R and 10L, or between the iliac artery and the femoral vein, and at locations within the aorta, as indicated at item 7. The artificial fistula may be maintained as an anatomical fistula, consisting of vascular tissue, if the local anatomy tends to heal to a stable and patent fistula, or it may be maintained by shunt or shunt rivet 8 as illustrated, or by an endoprosthesis (a vascular graft or stent graft) of significant length.

To regulate flow through the fistula, an inflatable cuff 11 is placed and implanted around the femoral vein, proximal to the fistula (closer to the heart relative to the fistula). The inflatable cuff is further illustrated in FIG. 2, which shows the inflatable cuff assembly which includes the cuff 11, secured around the vein with suture seam 12, a subcutaneous injection port 13 with a resealable membrane 14, and a short conduit 15 providing for fluid communication between the injection port and the cuff (the injection port and resealable membrane may also be formed integrally with the cuff). The cuff may also be installed over the femoral artery 3L, proximal to the fistula, as shown in FIG. 3. Inflation of the cuff results squeezing the blood vessel within the cuff, essentially throttling flow through the blood vessel. The degree to which flow is mediated or throttled depends on the degree to which the cuff is inflated.

FIGS. 4, 5 and 6 illustrate use of bladder which merely impinges on the femoral vein to control bypass flow. As shown in FIG. 4, a bladder is placed in immediate contact with the femoral vein 9. The fistula 7 is shown in phantom, and may be fitted with a shunt or rivet 8. The bladder 16 is an elongate bladder, which may be conformal or non-conformal, which is inflated through the associated access port 17. FIG. 5 shows a cross section of the leg, with the bladder uninflated, impinging on the femoral vein, while FIG. 6 illustrates the effect of the inflated bladder on the femoral vein. Upon inflation, the bladder further impinges upon the femoral vein to impede flow, and thereby impede bypass flow from the femoral artery to the femoral vein.

FIGS. 7 and 8 illustrate a bladder assembly which assists in operably coupling the bladder to the blood vessel, so that distention of the bladder is certain to result in impingement on the blood vessel. In FIG. 7, the bladder 16 is coupled to a band 21 which provides an anvil against which the balloon pushes the blood vessel, and prevents the blood vessel from merely moving in response to balder inflation. The band may be attached to the balloon at each end, as shown, or the band may be wrapped completely around both the bladder and the blood vessel. FIG. 8 illustrates another a bladder assembly which assists in operably coupling the bladder 16 to the blood vessel, so that distention of the bladder is certain to result in impingement on the blood vessel. In this figure, a relatively hard and rigid clip 22 is hinged or otherwise rotatably attached to the balloon at hinge point 23, on one end or the other, and is fastened with the hook or other closure mechanism 24 at the other, so that the bladder may be fastened to the blood vessel. The clip is narrow and elongate, so that it may be used as shown in FIG. 9, with the bladder 16 disposed in impinging relationship with the anatomical fistula 25 and the clip disposed on the opposite side of the fistula and closed upon the bladder or an extending structure (in this case, the conduit used to fill the bladder). If a graft of significant length is used, the devices of FIGS. 7, 8 and 9 may be placed over contiguous parallel segments of the shunt and artery, or the shunt and the vein.

Any other adjustable vascular impingement device may be used, including the Flow-watch®. pulmonary artery band system which includes a jack screw adjusted by a motor which is powered and controlled telemetrically, as described in Stergiopulis, Flow Control Device and Method, PCT App. PCT/EP00/06907 (Jan. 25, 2001), or screw operated bands such as those disclosed in Schlensak, et al., Pulmonary Artery Banding With A Novel Percutaneously, Bidirectionally Adjustable Device, 12 Eur. J. of Cardio-thoracic Surg. 931-933 (1997).

The devices and methods described above may be used to treat COPD as follows. First, a surgeon creates a fistula between an artery and a nearby vein. Preferably, the artery and vein are large, such as the femoral artery and the femoral vein. The fistula may be maintained, after artificial creation, either naturally to create an anatomical fistula comprising portions of the contiguous artery and vein healed together, or it may be a mechanically maintained fistula which is supported with a shunt or stent, or it may comprise a distinct shunt from the artery to the vein. After creating and stabilizing the fistula (ensuring that endoprosthesis are securely implanted, or that the anatomical fistula is structurally sound), the surgeon implants the flow restricting device (which may be any one of the devices described or mentioned herein) around the vein downstream from the fistula, or around the artery upstream from the fistula, or across the fistula itself. To control flow through the fistula, the cuff is inflated or deflated as necessary to achieve a desired bypass flow volume. The desired by-pass flow volume is determined by monitoring blood oxygenation and cardiac function intra-operatively (that is, immediately after creation of the fistula and implantation of the flow restricting device) and/or (that is, before discharge) and adjusting bypass flow to obtain a medically indicated short-term change in such parameters. The desired by-pass flow should also be determined and adjusted post-operatively, after a stabilization period (a few weeks after surgery). The shunt will increase mixed venous oxygenation, (SvO2), increase the percentage of oxygen bound to hemoglobin (SpO2), increase the amount of oxygen dissolved in blood plasma (PaO2), and increase cardiac output and stroke volume (after remodeling). Initially (immediately after opening the shunt) the heart rate increases to provide increased cardiac output. Then, as the heart ‘remodels’ the stroke volume increases and the heart rate comes back down to normal levels to maintain increased cardiac output. Lower bypass flow in the post-operative and stabilization time period may be desirable to avoid over stressing the heart and allow a more gradual cardiac re-modeling. Thus, the overall procedure may be accomplished by adjusting flow in the peri-operative and stabilization time frame to levels sufficient to increase PaO2 and/or SvO2 about 5% or more, and increase cardiac output by about 10% or more, followed by re-evaluation of the patient after stabilization and readjustment of by-pass flow to provide for an increase PaO2 and/or SvO2 (relative to pre-operative levels) of about 10% to 20% or more, depending on patient tolerance. Should the heart rate increase attendant to the bypass flow be more tolerable, the bypass flow in the peri-operative and stabilization time frame may adjusted to higher levels, to provide for an increase in PaO2 and/or SvO2 of about 20% to 25% (for a COPD with low PaO2 and/or SvO2), followed by re-evaluation of the patient after stabilization (after long-term remodeling of the heart, the heart may be remodeled in response to the therapy) and reduction of by-pass flow to provide for an increase PaO2 and/or SvO2 (relative to pre-operative levels) by about 10% to 20%. The optimal levels of these parameters, and the optimum trade-off between increased blood levels, cardiac output and increased heart rate are expected to be refined with clinical experience.

Rather than impinging on the blood vessel as described above, the desired flow control may be achieved by providing a shunt with a variable lumen cross-section or other flow control means which may act as a throttle valve. FIGS. 10 and 11 illustrate use of shunt with an integral bladder which may be inflated to control flow through the shunt, as desired to effect the arterial bypass flow as treatment for COPD. A shunt 26 is installed between the femoral artery and the femoral vein. The shunt additionally comprises a bladder 27 installed within the lumen of the shunt, which is filled as desired through the inflation port 28. As illustrated in FIG. 11, in which the bladder is partially inflated, the bladder partially occludes the shunt, to a degree dependent on the degree to which the bladder is inflated. The bladder may be fully inflated to fully occlude the shunt and prevent bypass flow. The shunt may be made of any suitable shunt material.

FIGS. 12 and 13 illustrate another mechanism for regulating fistula bypass flow, in which a membranous wall of the shunt may be magnetically drawn to control the size of the shunt lumen. In this embodiment, the shunt is provided with an rigid outer wall 29 and flexible inner wall 30. The dissectible portion of the inner wall which cuts across the lumen may be elastic or merely loose, so that it may be pulled against the outer wall to fully open the lumen. A magnet (or ferromagnetic mass) 31 is fixed to the dissectible portion of the inner wall, such that the magnet, and thus the dissectible portion of the inner wall, may be drawn against the outer by magnetic attraction to an extracorporeal magnet 32. The extracorporeal magnet may be an electromagnet with operating circuitry which is fixed to the patient in proximity to the shunt, or it may be a permanent magnet, the power of which may be selected to effect a desired degree of openness.

While the devices and methods have been described relative to the femoral artery and femoral vein, they may also be employed in other suitable contiguous or associated artery/vein pairs, including the aorta and inferior vena cava, the femoral vein and the iliopopliteal vein or iliac vein, the popliteal artery and popliteal vein, the carotid artery and the jugular vein, the brachial artery and brachial vein, the brachial artery and brachial vein, and the brachio-cephallic artery and subclavian vein. The artery-to-vein shunt may also be provided between remote anastomosis cites, such as the iliac artery to the inferior vena cava. Also, though discussed in terms of COPD treatment, the method should be useful to treat hypertension (pulmonary hypertension and arterial hypertension), left ventricular hypertrophy, and chronic hypoxia. Thus, while the preferred embodiments of the devices and methods have been described in reference to the environment in which they were developed, they are merely illustrative of the principles of the inventions. Other embodiments and configurations may be devised without departing from the spirit of the inventions and the scope of the appended claims.

Claims (13)

We claim:
1. A method of treating COPD in a patient, said method comprising the steps of:
identifying symptoms of COPD;
creating an artificial side-to-side fistula via a shunt between an artery and a vein of the patient such that an anatomical fistula of vascular tissue forms and blood flows through the shunt between the artery and vein until a blood plasma oxygen level (PaO2) and mixed venous oxygen level (SvO2) increases between 20% to 25% relative to the blood flow without the shunt;
evaluating the patient after a stabilization period following creation of the artificial side-to-side fistula, where the stabilization period is sufficient to allow for long-term remodeling of a heart of the patient;
adjusting the blood flow through the fistula by restricting flow through another region of the vasculature different from the shunt until the PaO2 and SvO2 levels are between 10% to 20%;
determining an optimum trade-off between a blood level, a cardiac output, and a heart rate of the patient; and
operating a flow-mediating device along the artery or vein to control bypass blood flow through the fistula as indicated to treat COPD.
2. The method of claim 1 further comprising operating the flow-mediating device to control bypass blood flow through the fistula to achieve an increase in the patient's cardiac output by at least about 10% as indicated to treat COPD.
3. The method of claim 1 further comprising adjusting the flow mediating device to control bypass blood flow through the fistula to achieve an increase in the patient's cardiac output by at least about 10%.
4. The method of claim 1 wherein installing a flow mediating device comprises providing an inflatable bladder system comprising an inflatable cuff adapted to substantially surround a portion of the patient's vasculature proximate the fistula.
5. The method of claim 1 wherein installing a flow mediating device comprises providing an inflatable bladder adapted to impinge upon a portion of the patient's vasculature proximate the fistula.
6. The method of claim 1 wherein installing a flow mediating device comprises providing a band adapted to surround a vessel of the patient's vasculature and securing a bladder to the patient's vasculature with the band proximate the fistula.
7. The method of claim 1 wherein operating comprises squeezing or releasing the flow mediating device to mediate flow through the shunt.
8. The method of claim 1 wherein installing a flow mediating device comprises placing the flow mediating device on the vein downstream from the fistula.
9. The method of claim 1 wherein installing a flow mediating device comprises placing the flow mediating device on the artery upstream from the fistula.
10. The method of claim 1 wherein creating an artificial fistula comprises creating the artificial fistula between a femoral artery and femoral vein of the patient.
11. The method of claim 1 wherein creating an artificial fistula comprises creating the artificial fistula between one of the following vein/artery pairs:
the aorta and inferior vena cava, the femoral vein and the iliopopliteal vein or iliac vein, the carotid artery and the carotid vein or jugular vein, the brachial artery and brachial vein, and the brachio-cephallic artery and subclavian vein.
12. The method of claim 1 wherein operating the flow mediating device comprises increasing the bypass blood flow such that cardiac output is increased.
13. The method of claim 1 wherein adjusting the blood flow comprises throttling the blood flow through the artery or vein to restrict the bypass blood flow through the fistula.
US13/529,364 2004-12-15 2012-06-21 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems Active US9011362B2 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US11/013,981 US8226592B2 (en) 2004-12-15 2004-12-15 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US13/529,364 US9011362B2 (en) 2004-12-15 2012-06-21 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US13/529,364 US9011362B2 (en) 2004-12-15 2012-06-21 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US14/671,509 US9669148B2 (en) 2004-12-15 2015-03-27 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US15/586,026 US20170232241A1 (en) 2004-12-15 2017-05-03 Method of treating copd with artificial arterio-venous fistula and flow mediating systems

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US11/013,981 Continuation US8226592B2 (en) 2004-12-15 2004-12-15 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US14/671,509 Continuation US9669148B2 (en) 2004-12-15 2015-03-27 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems

Publications (2)

Publication Number Publication Date
US20120316487A1 US20120316487A1 (en) 2012-12-13
US9011362B2 true US9011362B2 (en) 2015-04-21

Family

ID=36585005

Family Applications (4)

Application Number Title Priority Date Filing Date
US11/013,981 Active 2025-07-19 US8226592B2 (en) 2004-12-15 2004-12-15 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US13/529,364 Active US9011362B2 (en) 2004-12-15 2012-06-21 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US14/671,509 Active 2025-05-15 US9669148B2 (en) 2004-12-15 2015-03-27 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US15/586,026 Pending US20170232241A1 (en) 2004-12-15 2017-05-03 Method of treating copd with artificial arterio-venous fistula and flow mediating systems

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US11/013,981 Active 2025-07-19 US8226592B2 (en) 2004-12-15 2004-12-15 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems

Family Applications After (2)

Application Number Title Priority Date Filing Date
US14/671,509 Active 2025-05-15 US9669148B2 (en) 2004-12-15 2015-03-27 Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US15/586,026 Pending US20170232241A1 (en) 2004-12-15 2017-05-03 Method of treating copd with artificial arterio-venous fistula and flow mediating systems

Country Status (5)

Country Link
US (4) US8226592B2 (en)
EP (2) EP3132818A1 (en)
AU (1) AU2005316262B2 (en)
CA (1) CA2590370C (en)
WO (1) WO2006066210A2 (en)

Families Citing this family (25)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040087997A1 (en) * 2002-08-09 2004-05-06 Theracardia, Inc. Medical devices incorporating elastically deformable SIM elements
US20060047337A1 (en) 2004-08-27 2006-03-02 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US9706997B2 (en) 2004-08-27 2017-07-18 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US7828814B2 (en) 2004-08-27 2010-11-09 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US8226592B2 (en) 2004-12-15 2012-07-24 Rox Medical, Inc. Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US20130190676A1 (en) 2006-04-20 2013-07-25 Limflow Gmbh Devices and methods for fluid flow through body passages
SG11201506383VA (en) 2013-03-08 2015-09-29 Limflow Gmbh Methods and systems for providing or maintaining fluid flow through body passages
US20080300528A1 (en) * 2007-05-29 2008-12-04 Creativasc Medical Llc Arteriovenous access valve system and process
US8454632B2 (en) 2008-05-12 2013-06-04 Xlumena, Inc. Tissue anchor for securing tissue layers
US20100130835A1 (en) * 2008-09-30 2010-05-27 Rox Medical, Inc. Methods for screening and treating patients with compromised cardiopulmonary function
EP3138517A1 (en) * 2009-04-20 2017-03-08 Rox Medical, Inc. Device for establishing an artificial arterio-venous fistula
US9364259B2 (en) 2009-04-21 2016-06-14 Xlumena, Inc. System and method for delivering expanding trocar through a sheath
WO2011156176A1 (en) 2010-06-08 2011-12-15 Regents Of The University Of Minnesota Vascular elastance
CN105617474A (en) 2010-11-16 2016-06-01 Tva医疗公司 Devices and methods for forming a fistula
EP2854654A4 (en) 2012-05-17 2016-03-16 Xlumena Inc Methods and devices for access across adjacent tissue layers
CA2887557A1 (en) 2012-10-11 2014-04-17 Tva Medical, Inc. Devices and methods for fistula formation
WO2014210474A2 (en) * 2013-06-27 2014-12-31 Rox Medical, Inc. Methods, systems and devices for treating erectile dysfunction
US9421017B2 (en) 2014-01-15 2016-08-23 Jacques Seguin Methods and apparatus using branched balloon for treating pulmonary arterial hypertension
FR3017044A1 (en) * 2014-01-31 2015-08-07 Jacques Seguin Device for treating pulmonary arterial hypertension
US9427236B2 (en) 2014-01-31 2016-08-30 Jacques Seguin Methods and apparatus using an anchored balloon for treating pulmonary arterial hypertension
US9980813B2 (en) 2014-04-28 2018-05-29 Cook Medical Technologies Llc Selective fluid barrier valve device and method of treatment
US9545263B2 (en) 2014-06-19 2017-01-17 Limflow Gmbh Devices and methods for treating lower extremity vasculature
US8876850B1 (en) 2014-06-19 2014-11-04 Aria Cv, Inc. Systems and methods for treating pulmonary hypertension
US10039552B2 (en) 2014-10-28 2018-08-07 Cook Medical Technologies Llc Magnetically actuated gating devices, systems, kits, and methods
WO2018236835A1 (en) * 2017-06-19 2018-12-27 The Regents Of The University Of California Device and method for atraumatic and percutaneous formation of an arteriovenous fistula

Citations (78)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3538917A (en) * 1968-04-12 1970-11-10 Robert G Selker Balloon occlusion clip
US3675656A (en) * 1969-05-26 1972-07-11 Salomon Hakim Fluid operatable hemostat
US3730186A (en) * 1971-03-05 1973-05-01 Univ California Adjustable implantable artery-constricting device
US3853126A (en) * 1973-11-15 1974-12-10 Heyer Schulte Corp Artery-to-vein shunt
US3882862A (en) * 1974-01-11 1975-05-13 Olga Berend Arteriovenous shunt
US3903894A (en) * 1974-07-26 1975-09-09 Isaac Michael Rosen Implantable clamp
US4256094A (en) * 1979-06-18 1981-03-17 Kapp John P Arterial pressure control system
US4428365A (en) * 1982-03-01 1984-01-31 Hakky Said I Anti-incontinent prostheses
US4586501A (en) * 1982-10-21 1986-05-06 Michel Claracq Device for partly occluding a vessel in particular the inferior vena cava and inherent component of this device
US4601718A (en) * 1982-12-13 1986-07-22 Possis Medical, Inc. Vascular graft and blood supply method
US4708140A (en) * 1986-05-08 1987-11-24 Baron Howard C Atraumatic vascular balloon clamp
US4712551A (en) * 1986-10-14 1987-12-15 Rayhanabad Simon B Vascular shunt
US4828544A (en) * 1984-09-05 1989-05-09 Quotidian No. 100 Pty Limited Control of blood flow
US4881939A (en) * 1985-02-19 1989-11-21 The Johns Hopkins University Implantable helical cuff
US5108420A (en) 1991-02-01 1992-04-28 Temple University Aperture occlusion device
US5258042A (en) 1991-12-16 1993-11-02 Henry Ford Health System Intravascular hydrogel implant
US5267940A (en) * 1989-11-29 1993-12-07 The Administrators Of The Tulane Educational Fund Cardiovascular flow enhancer and method of operation
US5456712A (en) * 1991-07-03 1995-10-10 Maginot; Thomas J. Graft and stent assembly
US5491224A (en) 1990-09-20 1996-02-13 Bittner; Michael L. Direct label transaminated DNA probe compositions for chromosome identification and methods for their manufacture
US5507725A (en) 1992-12-23 1996-04-16 Angeion Corporation Steerable catheter
US5662711A (en) * 1995-06-07 1997-09-02 Douglas; William Flow adjustable artery shunt
US5756696A (en) 1986-01-16 1998-05-26 Regents Of The University Of California Compositions for chromosome-specific staining
US5830224A (en) 1996-03-15 1998-11-03 Beth Israel Deaconess Medical Center Catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a pre-chosen anatomic site in-vivo
US5830222A (en) 1995-10-13 1998-11-03 Transvascular, Inc. Device, system and method for intersititial transvascular intervention
US5843170A (en) 1994-09-02 1998-12-01 Ahn; Sam Seunghae Apparatus and method for performing aneurysm repair
US6053891A (en) * 1996-08-26 2000-04-25 Decampli; William M. Apparatus and methods for providing selectively adjustable blood flow through a vascular graft
US6120534A (en) * 1997-10-29 2000-09-19 Ruiz; Carlos E. Endoluminal prosthesis having adjustable constriction
US6152937A (en) 1998-11-06 2000-11-28 St. Jude Medical Cardiovascular Group, Inc. Medical graft connector and methods of making and installing same
US6174681B1 (en) 1999-03-05 2001-01-16 Mayo Foundation For Medical Education And Research Method and probe set for detecting cancer
WO2001005463A1 (en) 1999-07-19 2001-01-25 Endoart S.A. Flow control method and device
US6248117B1 (en) * 1999-04-16 2001-06-19 Vital Access Corp Anastomosis apparatus for use in intraluminally directed vascular anastomosis
US6315752B1 (en) * 1999-03-26 2001-11-13 Scimed Life Systems, Inc. Implantable bypass device
US6391036B1 (en) 1998-01-30 2002-05-21 St. Jude Medical Atg Inc. Medical graft connector or plug structures, and methods of making and installing same
US20020062146A1 (en) * 1996-10-11 2002-05-23 Joshua Makower Methods and apparatus for transmyocardial direct coronary revascularization
US6402767B1 (en) * 1997-05-22 2002-06-11 Kensey Nash Corporation Anastomosis connection system and method of use
US6443158B1 (en) * 1997-06-19 2002-09-03 Scimed Life Systems, Inc. Percutaneous coronary artery bypass through a venous vessel
US6451048B1 (en) 1997-10-09 2002-09-17 St. Jude Medical Atg, Inc. Wire connector structures for tubular grafts
US20020189727A1 (en) 2001-06-11 2002-12-19 Francis Peterson Method of training nitinol wire
US20030014003A1 (en) * 2001-06-20 2003-01-16 The Regents Of The University Of California Hemodialysis system and method
US20030088256A1 (en) 2001-10-03 2003-05-08 Conston Stanley R. Devices and methods for interconnecting vessels
US20030100920A1 (en) 1999-07-28 2003-05-29 Akin Jodi J. Devices and methods for interconnecting conduits and closing openings in tissue
US6579311B1 (en) * 1996-02-02 2003-06-17 Transvascular, Inc. Method for interstitial transvascular intervention
US6616675B1 (en) 1996-02-02 2003-09-09 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US6616624B1 (en) * 2000-10-30 2003-09-09 Cvrx, Inc. Systems and method for controlling renovascular perfusion
US6623494B1 (en) * 1999-04-16 2003-09-23 Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) Methods and systems for intraluminally directed vascular anastomosis
US6695878B2 (en) 2000-06-26 2004-02-24 Rex Medical, L.P. Vascular device for valve leaflet apposition
US20040087997A1 (en) 2002-08-09 2004-05-06 Theracardia, Inc. Medical devices incorporating elastically deformable SIM elements
US6743244B2 (en) * 1999-04-16 2004-06-01 Integrated Vascular Interventional Technologies, L.C. Soft anvil apparatus for cutting anastomosis fenestra
US6746426B1 (en) 2000-07-11 2004-06-08 Medtronic Vascular, Inc. Transluminally deliverable vascular blockers and methods for facilitating retrograde flow of arterial blood through veins
US6827698B1 (en) * 1999-04-16 2004-12-07 Fresenius Medical Care Deutschland Gmbh Method and device for determining blood flow in a vascular access
US20040249335A1 (en) * 2003-04-08 2004-12-09 Faul John L. Implantable arteriovenous shunt device
US20040249334A1 (en) * 2003-06-06 2004-12-09 Cull David L. Arteriovenous access valve system and process
US20050049675A1 (en) 2003-03-28 2005-03-03 Board Of Regents, The University Of Texas System Medical devices and related methods
US20050124892A1 (en) 2003-12-09 2005-06-09 The Regents Of The University Of Michigan Methods and systems for measuring mechanical property of a vascular wall and method and system for determining health of a vascular structure
US20050143766A1 (en) * 2002-09-04 2005-06-30 Endoart Sa Telemetrically controlled band for regulating functioning of a body organ or duct, and methods of making, implantation and use
US6926690B2 (en) 1998-09-10 2005-08-09 Percardia, Inc. Transmyocardial shunt and its attachment mechanism, for left ventricular revascularization
US6929011B2 (en) * 1996-08-13 2005-08-16 Percardia, Inc. Method to deliver blood from a heart chamber to a vessel
US20050215938A1 (en) * 2004-03-29 2005-09-29 Iftikhar Khan Hybrid arteriovenous shunt
US20050228402A1 (en) 2002-01-24 2005-10-13 Lawrence Hofmann Methods and devices for percutaneous and surgical interventions
US20050277967A1 (en) * 2004-06-14 2005-12-15 Rox Medical, Inc. Methods for providing oxygenated blood to venous circulation
US6979351B2 (en) * 2002-08-02 2005-12-27 Potencia Medical Ag Implantable ceramic valve pump assembly
US6985774B2 (en) * 2000-09-27 2006-01-10 Cvrx, Inc. Stimulus regimens for cardiovascular reflex control
EP1614400A2 (en) 1996-11-07 2006-01-11 St.Jude Medical ATG, Inc. Medical grafting apparatus
US7004175B2 (en) * 1997-03-06 2006-02-28 Scimed Life Systems, Inc. System and method for percutaneous coronary artery bypass
US20060047337A1 (en) 2004-08-27 2006-03-02 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US7011094B2 (en) 2001-03-02 2006-03-14 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US7056326B2 (en) 1998-01-23 2006-06-06 Heartport, Inc. System for performing vascular anastomoses
US7056325B1 (en) * 1997-06-28 2006-06-06 Medtronic Vascular, Inc. Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures
US20060129083A1 (en) 2004-12-15 2006-06-15 Rox Medical, Inc. Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US20060206123A1 (en) 2004-08-27 2006-09-14 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US20060293701A1 (en) 2001-05-02 2006-12-28 Medtronic, Inc. Self-closing surgical clip for tissue
WO2007005386A1 (en) 2005-06-30 2007-01-11 Rox Medical, Inc. Devices, systems, and methods for creation of a peripherally located fistula
WO2007014283A2 (en) 2005-07-26 2007-02-01 Rox Medical, Inc. Devices, systems, and methods for peripheral arteriovenous fistula creation
US20070299543A1 (en) * 2002-08-29 2007-12-27 Mitralsolutions, Inc. Implantable devices for controlling the internal circumference of an anatomic orifice or lumen
US7316706B2 (en) 2003-06-20 2008-01-08 Medtronic Vascular, Inc. Tensioning device, system, and method for treating mitral valve regurgitation
US7828814B2 (en) * 2004-08-27 2010-11-09 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US7967769B2 (en) 2003-04-08 2011-06-28 Rox Medical Inc. Implantable arterio-venous shunt devices and methods for their use
US8518062B2 (en) * 2000-04-29 2013-08-27 Medtronic, Inc. Devices and methods for forming magnetic anastomoses between vessels

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19508129C2 (en) * 1995-03-08 1997-02-13 Jan Dr Med Menke Blutdurchflußeinstelleinrichtung for optional external constriction and dilation of a blood vessel Blutdurchflußquerschnittes
US5866189A (en) * 1996-01-12 1999-02-02 Nestec S.A. Process of modifying texture of food products
US6102918A (en) 1998-02-18 2000-08-15 Montefiore Hospital And Medical Center Collapsible low-profile vascular graft implantation instrument and method for use thereof
SI9800177A (en) * 1998-06-19 1999-12-31 Klinični center Ljubljana Artificial vein
JP3926968B2 (en) * 2000-05-29 2007-06-06 明夫 川村 Non-puncturing type blood access for hemodialysis
US7623926B2 (en) * 2000-09-27 2009-11-24 Cvrx, Inc. Stimulus regimens for cardiovascular reflex control
WO2003063691A2 (en) * 2002-01-31 2003-08-07 Battelle Memorial Institute Anastomosis device and method
IL154531A (en) * 2003-02-19 2006-04-10 Yair Tal Device and method for regulating blood flow
US7540859B2 (en) * 2003-04-23 2009-06-02 Interrad Medical, Inc. Dialysis valve and method

Patent Citations (93)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3538917A (en) * 1968-04-12 1970-11-10 Robert G Selker Balloon occlusion clip
US3675656A (en) * 1969-05-26 1972-07-11 Salomon Hakim Fluid operatable hemostat
US3730186A (en) * 1971-03-05 1973-05-01 Univ California Adjustable implantable artery-constricting device
US3853126A (en) * 1973-11-15 1974-12-10 Heyer Schulte Corp Artery-to-vein shunt
US3882862A (en) * 1974-01-11 1975-05-13 Olga Berend Arteriovenous shunt
US3903894A (en) * 1974-07-26 1975-09-09 Isaac Michael Rosen Implantable clamp
US4256094A (en) * 1979-06-18 1981-03-17 Kapp John P Arterial pressure control system
US4428365A (en) * 1982-03-01 1984-01-31 Hakky Said I Anti-incontinent prostheses
US4586501A (en) * 1982-10-21 1986-05-06 Michel Claracq Device for partly occluding a vessel in particular the inferior vena cava and inherent component of this device
US4601718A (en) * 1982-12-13 1986-07-22 Possis Medical, Inc. Vascular graft and blood supply method
US4828544A (en) * 1984-09-05 1989-05-09 Quotidian No. 100 Pty Limited Control of blood flow
US4881939A (en) * 1985-02-19 1989-11-21 The Johns Hopkins University Implantable helical cuff
US5756696A (en) 1986-01-16 1998-05-26 Regents Of The University Of California Compositions for chromosome-specific staining
US4708140A (en) * 1986-05-08 1987-11-24 Baron Howard C Atraumatic vascular balloon clamp
US4712551A (en) * 1986-10-14 1987-12-15 Rayhanabad Simon B Vascular shunt
US5267940A (en) * 1989-11-29 1993-12-07 The Administrators Of The Tulane Educational Fund Cardiovascular flow enhancer and method of operation
US5491224A (en) 1990-09-20 1996-02-13 Bittner; Michael L. Direct label transaminated DNA probe compositions for chromosome identification and methods for their manufacture
US5108420A (en) 1991-02-01 1992-04-28 Temple University Aperture occlusion device
US5456712A (en) * 1991-07-03 1995-10-10 Maginot; Thomas J. Graft and stent assembly
US5258042A (en) 1991-12-16 1993-11-02 Henry Ford Health System Intravascular hydrogel implant
US5507725A (en) 1992-12-23 1996-04-16 Angeion Corporation Steerable catheter
US5843170A (en) 1994-09-02 1998-12-01 Ahn; Sam Seunghae Apparatus and method for performing aneurysm repair
US5662711A (en) * 1995-06-07 1997-09-02 Douglas; William Flow adjustable artery shunt
US5830222A (en) 1995-10-13 1998-11-03 Transvascular, Inc. Device, system and method for intersititial transvascular intervention
US6746464B1 (en) * 1995-10-13 2004-06-08 Transvascular, Inc. Device, system and method for interstitial transvascular intervention
US6616675B1 (en) 1996-02-02 2003-09-09 Transvascular, Inc. Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures
US6579311B1 (en) * 1996-02-02 2003-06-17 Transvascular, Inc. Method for interstitial transvascular intervention
US6669709B1 (en) 1996-03-15 2003-12-30 Transvascular, Inc. Catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a pre-chosen anatomic site in-vivo
US5830224A (en) 1996-03-15 1998-11-03 Beth Israel Deaconess Medical Center Catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a pre-chosen anatomic site in-vivo
US6099542A (en) 1996-03-15 2000-08-08 Beth Israel Hospital Association Inc. Catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a prechosen anatomic site in-vivo
US6929011B2 (en) * 1996-08-13 2005-08-16 Percardia, Inc. Method to deliver blood from a heart chamber to a vessel
US6053891A (en) * 1996-08-26 2000-04-25 Decampli; William M. Apparatus and methods for providing selectively adjustable blood flow through a vascular graft
US20020062146A1 (en) * 1996-10-11 2002-05-23 Joshua Makower Methods and apparatus for transmyocardial direct coronary revascularization
EP1614400A2 (en) 1996-11-07 2006-01-11 St.Jude Medical ATG, Inc. Medical grafting apparatus
US7004175B2 (en) * 1997-03-06 2006-02-28 Scimed Life Systems, Inc. System and method for percutaneous coronary artery bypass
US6402767B1 (en) * 1997-05-22 2002-06-11 Kensey Nash Corporation Anastomosis connection system and method of use
US6443158B1 (en) * 1997-06-19 2002-09-03 Scimed Life Systems, Inc. Percutaneous coronary artery bypass through a venous vessel
US7056325B1 (en) * 1997-06-28 2006-06-06 Medtronic Vascular, Inc. Transluminal methods and devices for closing, forming attachments to, and/or forming anastomotic junctions in, luminal anatomical structures
US6451048B1 (en) 1997-10-09 2002-09-17 St. Jude Medical Atg, Inc. Wire connector structures for tubular grafts
US6120534A (en) * 1997-10-29 2000-09-19 Ruiz; Carlos E. Endoluminal prosthesis having adjustable constriction
US7056326B2 (en) 1998-01-23 2006-06-06 Heartport, Inc. System for performing vascular anastomoses
US6391036B1 (en) 1998-01-30 2002-05-21 St. Jude Medical Atg Inc. Medical graft connector or plug structures, and methods of making and installing same
US6926690B2 (en) 1998-09-10 2005-08-09 Percardia, Inc. Transmyocardial shunt and its attachment mechanism, for left ventricular revascularization
US6152937A (en) 1998-11-06 2000-11-28 St. Jude Medical Cardiovascular Group, Inc. Medical graft connector and methods of making and installing same
US6376188B1 (en) 1999-03-05 2002-04-23 Mayo Foundation For Medical Education And Research Method and probe set for detecting cancer
US6174681B1 (en) 1999-03-05 2001-01-16 Mayo Foundation For Medical Education And Research Method and probe set for detecting cancer
US6315752B1 (en) * 1999-03-26 2001-11-13 Scimed Life Systems, Inc. Implantable bypass device
US6743244B2 (en) * 1999-04-16 2004-06-01 Integrated Vascular Interventional Technologies, L.C. Soft anvil apparatus for cutting anastomosis fenestra
US6827698B1 (en) * 1999-04-16 2004-12-07 Fresenius Medical Care Deutschland Gmbh Method and device for determining blood flow in a vascular access
US6248117B1 (en) * 1999-04-16 2001-06-19 Vital Access Corp Anastomosis apparatus for use in intraluminally directed vascular anastomosis
US6623494B1 (en) * 1999-04-16 2003-09-23 Integrated Vascular Interventional Technologies, L.C. (Ivit, Lc) Methods and systems for intraluminally directed vascular anastomosis
US7128750B1 (en) * 1999-07-19 2006-10-31 Endoart S.A. Flow control method and device
WO2001005463A1 (en) 1999-07-19 2001-01-25 Endoart S.A. Flow control method and device
US20030100920A1 (en) 1999-07-28 2003-05-29 Akin Jodi J. Devices and methods for interconnecting conduits and closing openings in tissue
US8518062B2 (en) * 2000-04-29 2013-08-27 Medtronic, Inc. Devices and methods for forming magnetic anastomoses between vessels
US6695878B2 (en) 2000-06-26 2004-02-24 Rex Medical, L.P. Vascular device for valve leaflet apposition
US6746426B1 (en) 2000-07-11 2004-06-08 Medtronic Vascular, Inc. Transluminally deliverable vascular blockers and methods for facilitating retrograde flow of arterial blood through veins
US6985774B2 (en) * 2000-09-27 2006-01-10 Cvrx, Inc. Stimulus regimens for cardiovascular reflex control
US6616624B1 (en) * 2000-10-30 2003-09-09 Cvrx, Inc. Systems and method for controlling renovascular perfusion
US20030199806A1 (en) * 2000-10-30 2003-10-23 Cvrx, Inc. Systems and methods for controlling renovascular perfusion
US7011094B2 (en) 2001-03-02 2006-03-14 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US20060293701A1 (en) 2001-05-02 2006-12-28 Medtronic, Inc. Self-closing surgical clip for tissue
US20020189727A1 (en) 2001-06-11 2002-12-19 Francis Peterson Method of training nitinol wire
US20030014003A1 (en) * 2001-06-20 2003-01-16 The Regents Of The University Of California Hemodialysis system and method
US20030088256A1 (en) 2001-10-03 2003-05-08 Conston Stanley R. Devices and methods for interconnecting vessels
US20050228402A1 (en) 2002-01-24 2005-10-13 Lawrence Hofmann Methods and devices for percutaneous and surgical interventions
US6979351B2 (en) * 2002-08-02 2005-12-27 Potencia Medical Ag Implantable ceramic valve pump assembly
US20040087997A1 (en) 2002-08-09 2004-05-06 Theracardia, Inc. Medical devices incorporating elastically deformable SIM elements
US20070299543A1 (en) * 2002-08-29 2007-12-27 Mitralsolutions, Inc. Implantable devices for controlling the internal circumference of an anatomic orifice or lumen
US20050143766A1 (en) * 2002-09-04 2005-06-30 Endoart Sa Telemetrically controlled band for regulating functioning of a body organ or duct, and methods of making, implantation and use
US20050049675A1 (en) 2003-03-28 2005-03-03 Board Of Regents, The University Of Texas System Medical devices and related methods
US20040249335A1 (en) * 2003-04-08 2004-12-09 Faul John L. Implantable arteriovenous shunt device
US20050107733A1 (en) 2003-04-08 2005-05-19 Faul John L. Implantable arterio-venous shunt devices and methods for their use
US7967769B2 (en) 2003-04-08 2011-06-28 Rox Medical Inc. Implantable arterio-venous shunt devices and methods for their use
US7628768B2 (en) * 2003-04-08 2009-12-08 Rox Medical, Inc. Implantable arterio-venous shunt devices and methods for their use
US20040249334A1 (en) * 2003-06-06 2004-12-09 Cull David L. Arteriovenous access valve system and process
US7316706B2 (en) 2003-06-20 2008-01-08 Medtronic Vascular, Inc. Tensioning device, system, and method for treating mitral valve regurgitation
US20050124892A1 (en) 2003-12-09 2005-06-09 The Regents Of The University Of Michigan Methods and systems for measuring mechanical property of a vascular wall and method and system for determining health of a vascular structure
US20050215938A1 (en) * 2004-03-29 2005-09-29 Iftikhar Khan Hybrid arteriovenous shunt
US8236014B2 (en) * 2004-06-14 2012-08-07 Rox Medical, Inc. Methods for arterio-venous fistula creation
US20050277967A1 (en) * 2004-06-14 2005-12-15 Rox Medical, Inc. Methods for providing oxygenated blood to venous circulation
US8016782B2 (en) * 2004-06-14 2011-09-13 Rox Medical, Inc. Methods for providing oxygenated blood to venous circulation
US20060047337A1 (en) 2004-08-27 2006-03-02 Brenneman Rodney A Device and method for establishing an artificial arterio-venous fistula
US20060206123A1 (en) 2004-08-27 2006-09-14 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US7828814B2 (en) * 2004-08-27 2010-11-09 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
WO2006026279A2 (en) 2004-08-27 2006-03-09 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US8088171B2 (en) * 2004-08-27 2012-01-03 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
US8273095B2 (en) * 2004-08-27 2012-09-25 Rox Medical, Inc. Device and method for establishing an artificial arterio-venous fistula
WO2006066210A2 (en) 2004-12-15 2006-06-22 Rox Medical, Inc. Method of treating copd with artificial arterio-venous fistula and flow mediating systems
US20060129083A1 (en) 2004-12-15 2006-06-15 Rox Medical, Inc. Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
US8226592B2 (en) * 2004-12-15 2012-07-24 Rox Medical, Inc. Method of treating COPD with artificial arterio-venous fistula and flow mediating systems
WO2007005386A1 (en) 2005-06-30 2007-01-11 Rox Medical, Inc. Devices, systems, and methods for creation of a peripherally located fistula
WO2007014283A2 (en) 2005-07-26 2007-02-01 Rox Medical, Inc. Devices, systems, and methods for peripheral arteriovenous fistula creation

Non-Patent Citations (9)

* Cited by examiner, † Cited by third party
Title
"Causes of Erectile Dysfunction", eMedicine Health website, http://www.emedicinehealth.com/causes-of-erectile-dysfunction/page3-em.htm.
"Causes of Erectile Dysfunction", eMedicine Health website, http://www.emedicinehealth.com/causes—of—erectile—dysfunction/page3—em.htm.
"Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet (Chronic Bronchitis and Emphysema)", Feb. 16, 2007, American Lung Association website, www.lungusa.org/site/pp.asp?e=dvLUK9O0E&b=35020.
"COPD: How is COPD Treated?", Feb. 16, 2007, National Heart Lung and Blood Institute Diseases and Conditions Index website, www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd-Treatments.html.
"COPD: How is COPD Treated?", Feb. 16, 2007, National Heart Lung and Blood Institute Diseases and Conditions Index website, www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd—Treatments.html.
"Lung-Treatment of COPD and Asthma", Feb. 16, 2007, NLHEP website, www.nlhep.org/lung.trtmnt.html.
"Lung—Treatment of COPD and Asthma", Feb. 16, 2007, NLHEP website, www.nlhep.org/lung.trtmnt.html.
Ruebben et al., "Arteriovenous fistulas induced by femoral arterial catheterization: percuntaneous treatment," Radiology, 209:729, 1998.
Schlensak et al., "Pulmonary Artery Banding with a Novel Percuntaneously, Bidirectionally Adjustable Device," Eur. J. of Cardio-thoracic Surg., pp. 931-933, 1997.

Also Published As

Publication number Publication date
EP3132818A1 (en) 2017-02-22
WO2006066210A3 (en) 2007-02-15
EP1830905A4 (en) 2013-02-06
AU2005316262A1 (en) 2006-06-22
WO2006066210A2 (en) 2006-06-22
CA2590370A1 (en) 2006-06-22
US8226592B2 (en) 2012-07-24
EP1830905A2 (en) 2007-09-12
US20170232241A1 (en) 2017-08-17
US20120316487A1 (en) 2012-12-13
US9669148B2 (en) 2017-06-06
US20150217039A1 (en) 2015-08-06
US20060129083A1 (en) 2006-06-15
CA2590370C (en) 2014-07-08
AU2005316262B2 (en) 2012-05-03
EP1830905B1 (en) 2016-08-17

Similar Documents

Publication Publication Date Title
Fontan et al. Surgical repair of tricuspid atresia
Lewis et al. Surgical repair of aortic root aneurysms in 280 patients
SVENSSON Rationale and technique for replacement of the ascending aorta, arch, and distal aorta using a modified elephant trunk procedure
US5679005A (en) Model of corrected transposition of the great arteries
US6669674B1 (en) Introducer and perfusion cannula
US6645193B2 (en) Slideable cannula and method of use
US20110203581A1 (en) Apparatus and method for deployment of a bronchial obstruction device
US9615911B2 (en) Delivery system for inflatable implant
US4501263A (en) Method for reducing hypertension of a liver
ES2356406T3 (en) Intravascular flow restrictor.
US6056717A (en) Implantable vascular device
US20070100314A1 (en) Apparatus and methods for treating congestive heart disease
Rokkas et al. Single-stage extensive replacement of the thoracic aorta: the arch-first technique
Rivers et al. Basilic vein transposition: an underused autologous alternative to prosthetic dialysis angioaccess
JP6126529B2 (en) Anastomotic device and method
US6261255B1 (en) Apparatus for vascular access for chronic hemodialysis
US20070167901A1 (en) Self-sealing residual compressive stress graft for dialysis
JP5693661B2 (en) Method and system for establishing a reverse flow of carotid blood flow
US6086553A (en) Arteriovenous shunt
Anderson et al. Early experience with adult extracorporeal membrane oxygenation in the modern era
US5807356A (en) Catheter with valve
EP1599240A4 (en) A method and catheter system applicable to acute renal failure
Lugli et al. Neovalve construction in deep venous incompetence
Papavramidis et al. Endoscopic management of gastrocutaneous fistula after bariatric surgery by using a fibrin sealant
Ando et al. Simultaneous graft replacement of the ascending aorta and total aortic arch for type A aortic dissection

Legal Events

Date Code Title Description
AS Assignment

Owner name: ROX MEDICAL, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BRENNEMAN, RODNEY A.;FLAHERTY, J. CHRISTOPHER;SIGNING DATES FROM 20120913 TO 20120920;REEL/FRAME:029029/0049

MAFP

Free format text: PAYMENT OF MAINTENANCE FEE, 4TH YR, SMALL ENTITY (ORIGINAL EVENT CODE: M2551)

Year of fee payment: 4